The goal of this project is to improve the design of spoken messages about health services for older adults. Spoken communication between health professionals and patients is becoming more frequent as automated telephone reminder systems gain currency in the health field. This rapid development in automated voice message technology has outstripped what we know about effective communication in this context. The proposed research will investigate the design of spoken messages about health services in order to improve comprehension, memory and adherence to messages about health services. We investigate the following message design issues: (a) Message content- What types of information are necessary for adherence? Do adults share preferences for how this information should be ordered in messages? (b) Message organization- Are messages more effective when organized to match reader preferences? We will test if spoken messages are easier to understand and remember when compatible with listener knowledge about the health care task. (c) Message length- How much information can be effectively conveyed in a reminder message? Can well-organized messages present more information than poorly organized messages? (d) Message modality- Many messages may be more effective when presented by voice than by print. Spoken pre-recorded messages have Increased adherence compared to no message control conditions. Yet there is little research on how much Information can be conveyed effectively by voice, or if interactive features such as message repeats or prompts improve recall. (e) Presentation of spoken messages- Can the impact of spoken messages on memory and adherence be enhanced by slowing presentation and stressing critical information? (f) Listener factors- To what extent do these message factors depend on listener age, education, perceived health status and self-efficacy, as well as beliefs about the health service? Listeners may need to be motivated to take advantage of well-designed communication. We investigate the influence of these message and listener factors on (a) message understanding and memory; (b) how accurately subjects assess their level of comprehension and memory (meta-cognitive abilities); (c) preferences for the messages, including beliefs about how motivating the messages are; (d) beliefs about the services described in the messages; and (e) beliefs about self-efficacy. Well-designed messages are most likely to improve adherence to health care services if they motivate as well as enable people to adhere by improving comprehension and memory. The final step in the research will be to measure the impact of well-designed messages on simulated adherence. The message design guidelines resulting from this research should help ensure that voice message technology, an increasingly frequent form of communication between health professionals and patients, addresses the needs of older adult patients.